Recently, I asked some of the online migraine community to suggest topics they'd like to see here. One person said she'd like to see, "How to Get Your Migraine Doctor to Hear You." It's a great topic, so I'm happy to write on it. I've also asked some fabulous migraine specialists to weigh in with some advice.
Let's begin with a few basics about patient/doctor communication:
- Communication with our doctors and getting our doctors to hear us is largely dependent upon having the right doctor.
- No doctor is the right doctor for every patient.
- Our perception of whether or not our doctors hear us can be influenced by personalities. Some doctors are very matter-of-fact, while others are warmer.
- If a doctor seems to not hear us about our migraines, it may be that the doctor doesn't understand migraine well enough to respond appropriately. It may well be time to look for a migraine specialist.
In order for our doctors to hear us, we need to communicate effectively, both verbally and nonverbally. Here are some suggestions:
- Don't "fake it" when you go to the doctor. When we go to see our doctors, there's no need to fake feeling well. We don't have to dress perfectly, put on makeup, or force a smile. It's helpful for our doctors to see US, not makeup, clothes, or fake smiles.
- When asked to rate your pain, be realistic. When we're asked to rate our pain on a scale of zero to five or zero to 10, saying, "12," is... well, it's not helpful — at all. See our video, How to Use the Pain Scale.
- Keep an accurate migraine diary, and take it with you. The information in our migraine diaries can be extremely valuable during our appointments with our doctors. It can help us spot patterns, identify triggers, and much more.
- Type a list with the questions you have and topics you want to discuss. When you type your list, leave space between the questions and topics to take notes. Print two copies so you have a copy for your doctor and a copy for yourself. Give it to your doctor at the beginning of your appointment so they're aware of your questions and what you want to discuss.
I asked some migraine and headache specialists to give us some advice on this topic.
David Dodick, M.D., FRCP, FACP, FAHS, told me:1
“Migraine often impacts every aspect of a person’s life — what they eat, when they eat, how they sleep (or don’t), whether they exercise, their work, their family, their academics, and their social life. I think it’s crucial for patients to communicate the profound impact migraine has on their lives, and the lives of those around them — because doctors may respond more to the impact of a disease than to the disease itself.”
Todd Schwedt, M.D., MSCI, FAHS, said:2
"It shouldn’t be difficult to get a caring and interested migraine doctor to actively listen to you. You can facilitate a meaningful interaction with your migraine doctor by preparing for your office visit in advance. Go into the visit knowing what your main goals are and share those goals with your doctor at the beginning of your conversation."
Dr. Schwedt also offered some examples to go with his advice, and said:2
- "maybe the main goal of a visit is to find non-pharmacologic methods for migraine prevention;
- maybe a patient is having intolerable side effects from a treatment and they want to change to another treatment;
- maybe a patient's main goal is to figure out a rescue therapy to keep them out of the emergency department, etc.
When a clinician has this info early during the appointment, the clinician can appropriately focus the interaction and recommendations."
David Watson, M.D., FAHS, FAAN, offered this advice:3
"It's important to give the story of your symptoms as concisely and as organized as possible. Your physician can then focus on what is important to you and not get the wrong impression of your main concerns.
If your migraine doctor is worth seeing, he or she will already understand that migraine can be severe and disabling. Saying things like your severity is 15/10, or that you literally thought your head would explode actually serve to minimize your symptoms."
There are several aspects to getting our migraine doctors to hear us. It takes partnering with the right doctor, and it takes work on both sides. If you feel your doctor doesn't hear you, I hope this helps you determine how to address the issue. If you have tips to add, please post a comment, and share with us.
More helpful articles:
Migraine Patient Guide to a Successful Doctor Appointment
Managing Migraine – Teri Robert and Dr. David Watson
Migraine and Headache 'Betters" - Better Treatment Partners
1 Email interview with David Dodick, M.D., FRCP, FACP, FAHS. January 18, 2017.
2 Email interview with Todd Schwedt, M.D., MSCI, FAHS. January 18, 2017.
3 Email interview with David Watson, M.D., FAHS, FAAN. February 20, 2017.